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NPI Code Detail

MEDICARE: JOHN PATRICK BOWDEN-LITTLE MPH, MA

MEDICARE: JOHN PATRICK BOWDEN-LITTLE MPH, MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMI

General Provider Information

NPI Number : 1629789953
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN PATRICK BOWDEN-LITTLE MPH, MA
Provider Business Mailing Address
First Line : 4205 COLLEGIATE WAY APT 131
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-7201
Country : US
Telephone Number : 989-860-9052
Fax Number :
Provider Business Practice Location Address
First Line : 2800 S SHEPHERD RD
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-8966
Country : US
Telephone Number : 989-775-4850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2022
Last Update Date : 12/07/2022

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